剖宫产瘢痕部位妊娠临床治疗分析

Clinical treatment of cesarean section scar pregnancy

目的探讨分析治疗剖宫产疤痕部位妊娠(CSP)的临床疗效。方法回顾性分析78例CSP患者的临床资料,将其依据治疗方式分为对照组(MTX+清宫术)27例及实验组(子宫动脉化疗栓塞+清宫术)51例,比较两组的临床及随访资料。结果实验组Ⅱ、Ⅲ型例数和治疗前血β-HCG水平、病灶体积、住院费用高于对照组,妊娠囊附着处肌层厚度、术中出血量、住院时间、血β-HCG降至正常时间则小于对照组,差异有统计学意义(P<0.05);实验组治疗40例有效,7例好转,4例无效,对照组治疗17例有效,6例好转,4例无效;两组治疗成功率、转经时间比较差异无统计学意义。结论 CSP治疗应综合临床分型、血β-HCG水平、病灶体积等因素进行个体化治疗;UACE配合清宫术疗效满意、安全可行,值得临床推广。

Objective To investigate the clinical effect of the treatment of cesarean section scar pregnancy(CSP).Methods Retrospectiveanalysis of the clinical data of78patients with CSP,which according to the treatment methods were divided into control group(27cases with MTX+and curettage)and experimental group(uterine artery embolization+curettage)in51cases,clinical and follow-up data were compared between thetwo groups.Results The experiment groupⅡ,Ⅲand the number of cases before treatmentβ-HCG level,tumor volume,cost of hospitalizationwas higher than the control group,the gestational sac attachment muscle thickness,amount of bleeding,hospitalization time,bloodβ-HCG droppedto normal time is less than that of the control group,the difference was statistically significant(P<0.05);the experimental group was effective in40cases,7were improved,4were invalid,the control group was effective in17cases,6were improved,and4were invalid,the two group of successfultreatment after time rate,no significant difference.Conclusion CSP treatment should be comprehensive clinical type,bloodβ-HCG level,lesion volume and other factors for individual treatment;UACE with curettage curative effect,safety and feasibility,worthy of promotion.